clinical approaches to hypoglycaemia Flashcards
what is the level 1 classification of hypoglycaemia?
A glucose alert value of 3.9 mmol/L (70 mg/dL) or less.
what is the level 2 classification of hypoglycaemia?
A glucose level of <3.0 mmol/L (<54 mg/dL) is sufficiently low to indicate serious, clinically important hypoglycemia
what is the level 3 classification of hypoglycaemia?
Severe hypoglycemia, as defined by the ADA, denotes severe cognitive impairment requiring external assistance for recovery
what are the clinical symptoms of hypoglycaemia?
hunger
weakness and fatigue
sweating
does the prevelance of severe hypoglycaemia get higher or lower the longer you live with the disease?
higher
what type of hypoglycaemia episode is more common-nocternal or day time?
nocternal
what are the consequences of a hypo episode in the brain?
Cognitive dysfunction
Hemiparesis
Seizures
Coma
Psychological (fear of hypoglycaemia)
what are the consequences of a hypo episode in the heart?
Myocardial infarction
Cardiac arrhythmias
Cardiac failure
what are the consequences of a hypo episode in the MSK system?
Falls
Fractures
Joint dislocations
Driving accidents
what are the consequences of a hypo episode for the circulation?
Inflammation
Blood coagulation abnormalities
Hemodynamic changes
Endothelial dysfunction
what are the risk factors for severe hypoglycaemia?
impaired hypo awareness
counterregulatory failure (C peptide nagative)
impaired renal function
autonomic neuropathy
Low hbA1c
genes
prior severe episode
which patient groups are most at risk
pre-school age
adolescence
elderly
comorbidities
low socioeconomic status
excessive alcohol consumption
Use of CNS-depressing agents
over ambitious attitude-multiple boluses to avoid hyper leads to severe hypo
what are comorbidities associated with hypoglycaemia?
coeliac disease
addisons/hypopituitarism
hypothyroidism
renal failure
gastroparesis
